Evaluation of the non-auditory responses in individuals with auditory brainstem implant.

OBJECTIVES: After auditory brainstem implant (ABI) surgery, stimulation of certain cranial nerves may result in a non-auditory response, and the electrodes that stimulate these nerves may be deactivated. The goals of this study are to compare the number of active electrodes in the initial activation and the last fitting, to investigate non-auditory response types and their frequency as a result of non-auditory stimulation, to compare the placements of deactivated electrodes as a result of non-auditory stimulation in the initial activation and the last fitting. METHODS: The computer software system was used to perform a retrospective analysis of the fitting data of 69 ABI users who underwent auditory brainstem implant surgery between January 1997 and January 2019. The non-auditory response types, deactive electrodes, and the positioning of the deactive electrodes horizontally and vertically were recorded in these users during the initial activation and the last fitting. RESULTS: There was no statistically significant difference between the number of active electrodes in the initial activation and the last fitting. The proportion of the users with deactive electrodes in the initial activation and the last fitting was not statistically significant different. In the horizontal and vertical placement classification, the placement of the deactive electrodes was not statistically different between initial activation and last fitting. The most common type of non-auditory response was facial nerve stimulation at the initial activation and no auditory perception at the last fitting. According to the difference between the number of active and deactive electrodes in the initial activation and the last fitting, as well as the auditory and non-auditory responses, it was found that the ABI users were statistically different between the initial activation and the last fitting. CONCLUSION: The results of this study show that not only auditory but also non-auditory responses occur in most ABI users. In addition, to the best of our knowledge, this study is the first to examine the frequencies of non-auditory response types, and the placement of the electrodes that cause these responses according to horizontal and vertical classifications.

Children with Auditory Brainstem Implant: How Do They Perform in Motor and Language Skills?

BACKGROUND: Young children are able to explore new objects and practice language through the acquisition of motor skills that lead to their overall development. Congenital hearing loss and total vestibular loss may contribute to the delay in speech and motor skill development. OBJECTIVES: To investigate the relationship between motor development performance, speech perception, and language performance in children with auditory brainstem implant (ABI). METHOD: Ten children, aged 4-17 years (mean age 9.76 ± 4.03), fitted with unilateral ABI for at least 2 years due to the presence of labyrinthine aplasia and rudimentary otocyst at least 1 side were included in the study. Several standardized tests, such as Bruininks-Oseretsky Motor Proficiency Test-2 (BOT-2), Children's Auditory Perception Test Battery, Meaningful Auditory Integration Scale (MAIS), and Test of Early Language Development-3, were performed to evaluate their skills of fine motor control, balance, manual dexterity, language, and auditory perception. RESULTS: A significant correlation was established between the BOT-2 manual dexterity and MAIS scores (r = 0.827, p < 0.05) and between the manual dexterity and language skills (for expressive language, r = 0.762, p < 0.05; for receptive language, r = 0.650, p < 0.05). Some of the BOT-2 balance tasks, such as standing on 1 leg on a line with eyes closed, standing on 1 leg on a balance beam with eyes open, standing heel-to-toe on a balance beam, and walking forward heel-to-toe on a line, showed a strong correlation with their receptive and expressive language performance (p < 0.05). CONCLUSION: The current study has indicated that significantly poor manual and balance performances are associated with poor speech perception and language skills in children with ABI. The authors recommend performing a vestibular assessment before and after ABI surgery and the use of a holistic rehabilitation approach, including auditory and vestibular rehabilitation, to support development of the children with ABI.

Development and evaluation of the Turkish matrix sentence test.

OBJECTIVES: The Turkish matrix sentence test, TURMatrix, was developed for precise, internationally comparable speech intelligibility testing. DESIGN: The TURMatrix comprises a base matrix of ten well-known Turkish names, numbers, adjectives, objects, verbs, from which syntactically fixed sentences were randomly composed. Test conduction may be in an open-set (standard), or closed-set response format. Homogeneity in intelligibility of the test material was optimized by applying level adaptations (maximal ± 3 dB) based on word-specific speech reception thresholds (SRTs). Test list equivalence was verified and reference values were determined. STUDY SAMPLE: Thirty-eight native listeners of Turkish with normal hearing. RESULTS: After training, mean SRT and slope of the final test lists were -8.3 ± 0.2 dB SNR and 14.1 ± 1.0%/dB, respectively (fixed SNR measurements; inter-list variability). For adaptive measurements, average across listeners was -7.2 ± 0.7 dB SNR in the open-set and -7.9 ± 0.7 dB SNR in the closed-set response format. Mean SRT for adaptive measurements in the open-set response format in quiet was 20.3 ± 4.1 dB. Individual SRTs in quiet correlated more closely with audiograms than with SRTs in noise. CONCLUSIONS: The TURMatrix was developed according to European standards and provides reliable speech intelligibility measurements in noise and quiet.

The family oriented musical training for children with cochlear implants: speech and musical perception results of two year follow-up.

OBJECTIVE: The purpose of this study is to determine whether children can gain benefit from training on pitch and music perception. Our main goals were to prepare a tool for training pitch and rhythm perception and evaluate musical attitude in children, to determine whether pitch and rhythm perception improve more rapidly through training and to assess the impact of training on speech perception. METHOD: A family centred habilitation program based on musical training is developed. Nine newly implanted children who were switched on in HiRes and trained from the outset and 9 children using HiRes strategy who did not receive training both undergo assessments to determine pitch and rhythm perception skills and speech perception assessments. Music group was formed by the children who were implanted consecutively. As a control group, children who are being followed for another study which examines "the changes of sound quality perception, speech understanding, speech production, and communication mode" are included. The speech perception test battery contains a comprehensive range of age appropriate tasks covering detection, discrimination, identification, recognition and comprehension abilities. Also meaningful auditory integration scale (MAIS) or infant-toddler MAIS (if more appropriate) and the meaningful use of speech scale (MUSS) were administered in order to collect information about children's use of sound in everyday situations such as device bounding, alerting to sound and deriving meaning from auditory stimuli. Musical training program was based on a take-home electric keyboard which is used for listening to different pairs of notes. For this study, three octaves and one extra note at the high end of the keyboard were used. Children were expected to discriminate a pair of notes. Assessments of speech perception at pre-implant, 1-, 3-, 6-, 12-, 24-months post switch-on. By the end of the first and second years, parents were given the 'musical stages questionnaire' which covers some of the key areas of musical development to compare both groups' musical development. RESULTS: Children who were involved in music study demonstrated significant familiarity in both determining pitch differences. No significant difference was found between music group compared with the non-trained group in terms of speech perception (p>0.05). However, by the end of 3rd month, music group came into prominence particularly at the rate of being linguistically/developmentally ready to carry out formal modified open-set speech perception evaluation (p<0.05). Both groups seemed to be developed similarly in sound awareness and general reaction, differentiating melody, dynamic, rhythmical changes and emotional aspects of musical development (p>0.05) whereas music group had more exposure to music at the end of the first year (p<0.05). However, by the end of the second year music group developed more than the control group in all aspects of musical skills (p<0.05). CONCLUSION: Music training program helps appreciation of music and may enhance their progress in other auditory domains after cochlear implantation in children. While, effects of the musical training program on daily listening attitudes and social aspects such as closer parent-child relationship were significantly observed future training programs that should strive to improve satisfaction with music listening and its effect on auditory perception.